Discitis after lumbar disc surgery. Features of "aseptic" and "septic" forms.

Two major types of postoperative discitis have been previously described: septic discitis and "avascular" or "chemical" discitis. Percutaneous discal biopsy is an important way of distinguishing these entities. In a retrospective study of 25 cases of postoperative discitis, three groups have been analyzed with bacteriologic and histologic tests: a group of nine patients (group A) with positive discal bacteriologic cultures; a group of eight patients (group B) with typical septic histologic tests but negative bacteriologic discal procedures; and a group of eight patients (group C) in whom the histologic picture was reminiscent of a mechanical process. No group was unique in any clinical and radiologic parameter. Group A and group B were quite similar in biological features, but group C had erythrocyte sedimentation rate and C-reactive protein serum levels significantly lower than groups A and B (P less than 0.01). After 4 weeks, these differences were still present. This study confirms that there are two main features of postoperative discitis that can be recognized by histologic and biological tests, allowing for different treatments.

[Cirrhosis induced by vitamin A]. / Cirrhose induite par la vitamine A.

The case of a 75-year-old woman who had been treated for 12 years by vitamin A (250,000 UI/day) for psoriasis is presented. During the hospitalisation, hepatic cirrhosis was detected and attributed to hypervitaminosis A based on disease history, clinical hypervitaminosis A features, increased vitamin A blood values and histological patterns, i. e. perisinusoidal fibrosis and spontaneous fluorescence of lipid vacuoles within fat-storing cells. Thus, although rare, vitamin A intoxication can be responsible for cirrhosis.

Role of the mitogenic property and kinase activity of p60src in tumor formation by Rous sarcoma virus.

Expression of the src gene of Rous sarcoma virus in chicken embryo neuroretinal cells results in morphological transformation and sustained proliferation of this normally resting cell population. PA101 and PA104 are two mutants of Rous sarcoma virus which induce neuroretinal cell proliferation in the absence of morphological transformation. Their mitogenic property is temperature sensitive, and they both encode p60src proteins with low kinase activity. To study the role of the mitogenic function and protein kinase activity of p60src in tumorigenesis, we investigated the oncogenicity of PA101 and PA104. Both mutants were less tumorigenic than wild-type virus when injected into chicks. Tumorigenicity was further assayed by inoculating infected chicken embryo fibroblasts and neuroretinal cells onto the chorioallantoid membrane of embryonated duck eggs. This system provides a nonpermissive and immunodeficient environment for xenogenic cell grafting and allows the study of cell tumorigenicity within a temperature range of 37 to 39.5 degrees C. Chicken embryo fibroblasts and neuroretinal cells infected with PA101 were as tumorigenic as wild type-infected cells at 37 degrees C, but tumor development was significantly reduced at 39.5 degrees C. In contrast, both cell types infected with PA104 displayed sharply reduced tumorigenicity. Cell cultures derived from PA101 tumors induced on the chorioallantoid membrane were similar to the corresponding cells maintained in vitro in terms of morphology, production of plasminogen activator, relative amounts of phosphotyrosine in total cellular proteins, and phosphorylation of 34,000-molecular-weight protein. These results indicate that the expression of the mitogenic function of src does not account per se for cell tumorigenicity and that tumor formation is compatible with low levels of p60src protein kinase activity.

Carcinoid tumor occurring in a teratoid malformation of the kidney. An immunohistochemical study.

A case of a carcinoid tumor of the kidney that was intimately related to a mixed dysplastic and teratomatous lesion is reported. This lesion displayed focal transitional, mucinous, and endocrine differentiations. Immunofluorescence studies permit the identification of three immunoreactive products: somatostatin, glucagon, and serotonin. It is suggested that the carcinoid tumor arises from this peculiar lesion, which exhibits cells of endocrine lineage.

[Bartter's syndrome: seven cases in siblings. Hypothesis of mild forms (author's transl)]. / Syndrome d Bartter chez 7 enfants d'une même fratrie. Existence de formes intermédiaires.

Three children with a Bartter's syndrome have been investigated: all of them had growth retardation, hypokalemia (less than 3 mmol/l), raised plasma renin activity and urinary prostaglandins (PGE2 and PGF2 alpha) and a decreased sensibility for angiotensin. In the siblings two children had also growth retardation with mild biological signs of Bartter's syndrome, and two children had normal growth slight hypokalemia raised RPA and urinary PH, and normal sensibility for angiotensin. These data suggest mild forms of this syndrome which could be the Bartter's syndrome diagnosed in adults after laxatives or diuretics absorption. Besides these data stated a negative correlation (p less than 0,01) between plasma K+ and RPA, negative correlation (p less than 0,01) between plasma K+ and urinary PGE2 and a positive correlation (p less than 0,01) between RPA and urinary PGE2. From these observations physiopathology of Bartter's syndrome is discussed.

[Thyroid nodules. A report on 320 cases (author's transl)]. / Les nodules thyroïdiens. Résultats de 320 observations.

An analytical study of 320 case reports of patients with one or more thyroid nodules, 246 of whom had been operated upon, revealed the presence of 32 cancers, 15 toxic nodules, and 195 inactive benign uni- or multilobular goitres. Complementary examinations (scintigraphy with technetium, thermography, ultrasonography) cannot definitely establish the benign nature of a nodule. As long as cytological examination after needle biopsy, which requires the services of a highly specialised cytologist, will not become a routine procedure, histological examination is essential for correct diagnosis. Any nodule should be excised, therefore, and the thyroid explored completely.

[Tumor of the adrenal gland associating pheochromocytoma and ganglioneuroma (author's transl)]. / Tumeur surrénalienne associant phéochromocytome et ganglioneurome.

An adrenal gland tumor associating of both a pheochromocytoma and a ganglioneuroma was discovered upon its fissuration in a 58-year-old male having a family history of neurofibromatosis. The patient's clinical course was fatal due to complications of necrotizing enteritis which was discovered at laparotomy. The association of pheochromocytoma, ganglioneuroma, and "café au lait" spots in the same patient illustrates the polymorphism of neural crest dysgenetic pathology.

[Renal leiomyoma. Apropos of a case]. / Léiomyome rénal. A propos d'un cas.

Leiomyoma of the kidney is a rare tumor, for which little investigational imaging data is available, and which is poorly characterized by histological methods. We are here concerned with one case that benefitted from an extensive radiological workup, and we provide a comparison with other cases mentioned in the literature.